About 20% of pregnant women smoke cigarettes, 12% drink alcohol and 6% use an illicit drug at least once during pregnancy. These numbers are very alarming. If only people knew the dangers of their decisions, perhaps we would be looking at something more acceptable in those numbers.

So what are some of the dangers posed by these substances to a developing fetus?

If Dr. Frances Oldham Kelsey had been named Mary, Helen, or Dorothy, it’s possible that thousands of babies would have died or been born with debilitating birth defects.

In the mid-1930s, after earning a master’s degree in pharmacology in her native Canada, Frances Oldham wrote to Eugene Geiling, a researcher at the University of Chicago, asking to work in his lab and study for a doctorate. Assuming Frances was a man, Dr. Geiling replied with an offer of a scholarship, addressing the letter to “Mr. Oldham.”

Dr. Kelsey upends the stereotype of the government bureaucrat. She saved lives by being a stickler for details.

Reflecting on the incident in an autobiography, she remembered Dr. Geiling as a “very conservative and old-fashioned” man who “did not hold too much with women as scientists.” His assumption that Frances Oldham was male might have played a role in her scholarship and subsequent education, which prepared her for a career that touched every American.

From an Early Victory in Chicago to a New Career in Washington, D.C.

After moving to Chicago, Frances Oldham earned a doctorate in pharmacology in 1938 and a medical degree in 1950. Along the way, she got married, becoming Dr. Frances Oldham Kelsey, and gave birth to two daughters.

Her work in Dr. Geiling’s lab provided early experience in unraveling medical mysteries. In 1937, more than 100 people, including 34 children, died after taking a liquid sulfa drug formulated with an artificial fruit flavor. Dr. Geiling’s team of scientists soon identified the problem: The medicine was composed primarily of antifreeze — along with the active ingredient, coloring, and flavorings. It was sent to market with no testing. Public outrage led to the 1938 passage of the Food, Drug, and Cosmetic Act, which required manufacturers to provide evidence to the FDA that their drugs were safe. Continue reading →

I first heard of Zika virus in an epidemiology class, when another student made on offhand remark: “Did you know Zika virus can be transmitted sexually?” Ever vigilant for material for the STD Awareness column, I excitedly scribbled the name of the virus in my notes. But upon further investigation, I found that there were only a couple of documented cases of the sexual transmission of this virus that no one had heard of, and decided there was no reason to freak people out about yet another potential STD when rates of more common STDs, like chlamydia and gonorrhea, were on the upswing.

A year later, Zika virus was splashed across headlines on a daily basis, mostly for its newfound association with birth defects, but also in light of revelations that it could be transmitted by sex.

Access to condoms and reliable contraception is more vital than ever.

While Zika virus is usually transmitted by mosquito bites, the discovery that it can be sexually transmitted made it the only known virus that could be spread both sexually and by mosquitoes. It’s also the only known mosquito-borne virus that can cross the placenta to harm a fetus. Like several other viruses, including CMV and rubella, Zika is implicated in serious birth defects. But many health authorities worry that its potential as a sexually transmitted pathogen is dangerously underestimated. As of August 31, there have been 23 confirmed sexually transmitted cases of Zika virus in the United States — but sexual transmission will rise as the virus jumps into local mosquitoes, which will also make it difficult or impossible to tell if a sexually active Zika patient got the virus from sex or directly from a mosquito.

Earlier this year, sexually transmitted Zika virus in Texas made headlines, with many journalists incorrectly proclaiming it the first known case of sexual transmission. In fact, Zika’s sexual transmission was first documented in 2008, before “Zika” was a household name and the married couple who published their experience in a scientific paper thought they could share their STD status in relative obscurity. Despite referring to themselves as “Patient 1” and “Patient 3,” a science reporter quickly figured it out and (with their permission) revealed their identities in a 2011 article — still years before Zika-bearing mosquitoes would hit the Americas and trigger a microcephaly epidemic that propelled the virus to infamy. Continue reading →

Pop quiz: Can you name the virus that most commonly infects developing fetuses when they are still in the womb?

Here’s a hint: June is National Congenital Cytomegalovirus Awareness Month.

In case that clue didn’t make it obvious enough, I’ll tell you the answer. The most common infection among developing fetuses is caused by a virus you might not have heard of: cytomegalovirus, or CMV. Around 30,000 children are born with this infection every year, and some of these babies will go on to develop serious problems because of it. National Congenital Cytomegalovirus Awareness Month is a time to learn about how CMV can affect pregnancy.

Cytomegalovirus can damage developing brain cells early in an embryo’s gestation.

This year, it might be of even greater interest, given the parallels that can be drawn between CMV and Zika virus, the emerging pathogen that has been dominating headlines lately. First of all, both CMV and Zika virus can be transmitted sexually, though they are not the first things you think of when the topic of STDs comes up, as they are overshadowed by more famous sexually transmitted viruses like herpes and human papillomavirus. While many of us are infected with CMV as children, we can also be infected as adults, often through sexual transmission — the virus can be found in cervical and vaginal secretions, saliva, and semen. The sexual transmission of Zika virus is not as well understood, but we know it can be found in semen, and there are documented cases of men passing the virus to sex partners through vaginal and anal intercourse. It might even be transmitted from a male to a partner by oral sex.

Second of all, both CMV and Zika virus are associated with birth defects. However, while the connection between CMV and birth defects has been known to us for decades, it was only in April that the Centers for Disease Control and Prevention concluded that Zika virus can cause fetal brain defects (though we’re still waiting for conclusive proof). Microcephaly is probably the most infamous of the birth defects associated with Zika virus, as well as CMV, but it’s not well defined. When you get down to it, though, microcephaly just refers to an abnormally small head, which itself might be indicative of a brain that has failed to develop fully. Continue reading →

Becoming a mother is a wondrous event. It is also a lifelong commitment to another special human being, your child. To provide your new baby with the best start in life, taking care of yourself in your childbearing years is essential. When you think that half of all pregnancies in the United States each year are unintended, it’s very important to follow a healthy lifestyle every day to ensure a good pregnancy and a good start for your baby.

Sunday is Mother’s Day. To those of you planning a pregnancy or hoping to be a mother someday, this is for you.

The United States does not fare as well as many other industrialized countries when it comes to the health of its newborns. Preterm births and low birth-weight babies are often the result of unhealthy pregnancies and a lack of prenatal care. New information and research has given us lots of good information about what is important to do before and during your pregnancy to increase your chances of having a healthy baby. Having a plan about when you want to start a family and what you intend to do to get yourself in the best health possible is a good start. This is called preconception health care, and it can make a big difference in the well-being of you and your baby.

At Planned Parenthood Arizona, you can see us for preconception health checkups. In addition to pregnancy planning services and fertility awareness education, we provide other services that can help you be in the best health possible before you conceive. We offer physical exams as part of our general health care services. You also might be interested in STD screening, to ensure that you receive treatment before you become pregnant. Additionally, we offer smoking cessation, to help you quit smoking for a tobacco-free pregnancy.

Here are some guidelines for ensuring your preconception health:

Plan when you want to have a family and space your pregnancies. Be sure you are ready for the responsibility and expense of a child. If it’s not your first child, wait 18 to 24 months before having an additional child to allow your body to recover and prepare for another pregnancy. Continue reading →

September 9 is Fetal Alcohol Awareness Day. At 9 a.m. the bells of the St. Augustine Cathedral in downtown Tucson will ring, so we can remember on the ninth hour of the ninth day of the ninth month not to drink alcohol during the nine months of pregnancy.

Fetal alcohol syndrome is entirely preventable.

I became aware of fetal alcohol syndrome the way many parents do — by dealing with a child affected by a mother’s drinking while pregnant. I had to learn about it to parent my son, who had come to me when he was 7 years old, and who, in his teens, had regressed in his emotional and cognitive functioning. I needed to understand the outbursts that resulted in holes punched or kicked in the walls; broken mirrors, broken windows, broken china; stolen jewelry, my winter jacket that I saw walking down the street worn by his friend, who had given money for it; the daily swearing and the inability to understand that his behavior had consequences.

Fetal alcohol syndrome is the leading cause of IQ scores below 70 in this country (though most people with FAS have normal intelligence), and is entirely preventable. You have probably seen ads talking about the importance of not drinking during pregnancy. But it is not only women of childbearing age who need to be educated. Doctors, especially ob/gyns and pediatricians, teachers, and social workers — everyone who works with children, in fact — need to learn about the effects of prenatal exposure to alcohol. Also judges, probation officers, and others working in the juvenile and adult criminal justice systems need to be educated; most of them have quite a bit of contact with the victims of fetal alcohol exposure, whether diagnosed or not. Continue reading →

“When was the last time you had your thyroid checked?” the nurse practitioner asked me. I was at my annual exam, discussing heavy menstrual bleeding.

“I’m not sure,” I replied. “Maybe never?”

Really, I was thinking to myself, What’s a thyroid?

As it turns out, the thyroid gland does a lot of the work that regulates the body’s metabolism, which is sort of a big deal for overall health. It means that when the thyroid is overactive — as in the case of hyperthryoidism — or when the thyroid is underactive — as in the case of hypothyroidism — symptoms can show up in a variety of areas, such as: Continue reading →